Provider Credentialing

Simply put, provider credentialing is the process of verifying the qualifications of licensed medical professionals to confirm the legitimacy of their practice. When the health care institution and network of providers you are using do not conduct their credentialing services, you need to contact our team.

We are here to make sure that everyone’s qualifications are legitimate and up-to-date. This allows the health care provider to be paid properly for the services that were provided to the patient. This process is very time-consuming and often quite complex, so if the health care provider you went to doesn’t offer their credentialing service – we are the number one team to choose.

Professional, Efficient Medical Credentialing

As an expert in medical credentialing and contracting, we understand how difficult the task of credentialing is. That’s why we have made it our specialty.

We are here so you don’t have to deal with the headache of filling out all the complicated paperwork. We also know that you are very busy and have a lot on your plate. Our experience allows us to provide San Francisco with prompt and thorough medical credentialing, so you don’t have to worry about it anymore. Just get in touch with our team if you have any questions about the process, and we will walk you through it.

Our lines are always open – if you want to fast-track your medical credentialing process, one of our friendly representatives will help you out.

The Medical Credentialing and Contracting Process

Any facility that wishes to bill an insurance company and receive reimbursement for the services provided must undergo credentialing. During the process of credentialing the health care provider is screened by the insurance company to verify the health provider’s education, training, experience, and competency. Once done, the health provider submits a credentialing application that outlines their area of practice and level of specialty.

We are the professional credentialing company to handle this complex task. After verification is completed, the insurance company decides whether the application is approved according to their criteria and, if it all checks out, the provider is paid properly.

Provider Focused Credentialing Service

Credentialing is needed for many different medical services and typically takes about 2-4 months, depending on the payor. Our job is to make the process more efficient for providers to get officially contracted and approved by the insurance companies. Our job is to handily take each case through:

• The documentation process
• Payer submission
• Enrollment
• Updates and re-credentialing

Documentation is collected and validated before the top payers are identified. Applications are followed up promptly to obtain enrollment, and periodically they will need to be updated.

We are here to eliminate redundant administrative processes between insurance companies and health providers and are here to make things easier. If you need the convenience of a professional medical credentialing service, we are the team to call.

Medical Credentialing Services: Timely, Accurate, and Professional

Our services are ideal for providers who are looking to be contracted with an insurance company. We’ll make sure that your portfolio is up-to-date and accurate so that you can build a strong relationship with your affiliates.

As a doctor credentialing expert, we provide the following services:

• Credentialing Support—We can assist you in compiling a current set of credentials, resume, and CAQH profile to distribute to insurance companies. We’ll help you create a strong first impression so that you prove yourself to be a trusted medical provider.
• Credentialing Maintenance—We offer regular maintenance services to keep your portfolio up to date for insurance companies. We’ll respond to all requests for current information, making sure that your profile is clear and accessible for the CAQH and insurance companies.

Medical Contracting and Network Participation

Raise Your Status

Through our medical contracting services, we help providers manage their reputations and expand your network of clients and partners. We represent you so that you can raise your profile as a medical professional.

We’re available to represent you in the following capacities:

• Communication and correspondence with insurance affiliates
• Enrollment with insurance companies
• Updating your credentials and practice details
• Terminating registration with insurance companies

Our contracting services help you become more visible to potential new patients by taking the stress of networking off your shoulders. We’ll expand your reach with insurance companies, helping you become a member of their Preferred Provider programs so that you become more visible to potential new patients. That way, you can grow your practice and continue to aid those who most need your assistance.

Leave the liaising to us. We’ll do what we do best so that you can do what you do best.

Insurance Credentialing Consultations

As part of our efforts to instill confidence in our services, we are proud to offer client-focused consultations completely free of charge. This will give you a chance to ask us any questions you may have about the process and confirm that we are the company for you. Once everything is on the table, and you have decided to hire us, we will get to work on compiling your information for verification. We look forward to hearing from you, so feel free to reach us today. 

Expedited Credentialing Process

We work diligently to ensure that all our clients get timely service. We know that you are coming to us to improve your reputation and verify your qualifications with your patients’ insurance companies, which is why we pride ourselves on efficient processing. A slow turnaround time can result in missed opportunities to provide care, which is why we do everything we can to offer swift credentialing services. 

What to Expect from Medical Credentialing

If you know that you could benefit from physician credentialing but would also like to know more about what the process entails, we are happy to provide more information. Our streamlined credentialing process is designed to minimize downtime and get you verified in the easiest way possible, so you don’t have to worry about any unnecessary busywork when you work with us. Here’s what you can expect from our client-focused credentialing process:

• Gather your information – We will provide you with a detailed breakdown of the information we will require to create an accurate profile of your practice. We make sure that everything is clearly spelled out for you, so none of your licenses or education are overlooked. 
• Verify the information – At this point, we will do all the legwork to validate your information and make sure you are a reputable practitioner in the eyes of insurance companies. This includes corresponding with licensing agencies, medicals schools, and more to ensure that all the credentials you provided us with are correct.
• Provide you with the verified credentials – Once we have determined that there are no errors with the information you provided, we will be able to award you with insurance crediting. This will help you become an approved practitioner with various insurance companies.